Fall is here and winter is just around the corner, which will usher in another “sick season”. I am already thinking about illness as I just finished reading a JAMA article about the overuse of antibiotics. Did you know that the CDC estimates that “30% of antibiotic prescriptions in the U.S. are unnecessary”?
The CDC reported that the majority of these misused antibiotics were prescribed for viral upper respiratory infections including the common cold, bronchitis and sinus and ear infections. Which gets me back to “sick season” and the busy pediatric office.
Parents frequently bring their child in for one of the many viral upper respiratory infections that a child has, especially in the first 5 years of life, and “assume” that they will receive an antibiotic. In fact, I am still amazed that with all of the news about “superbugs” and emerging antibiotic resistance, some parents continue to “push” for a antibiotic because their child has had a fever, cough and runny nose for several days.
The head of the CDC recently stated, “antibiotics are lifesaving drugs and if we continue down the road of inappropriate use, we will lose the most powerful tool we have to fight life threatening infections”. In other words, we doctors need to be very judicious when deciding to prescribe an antibiotic and patients need to ask questions as to the necessity for taking an antibiotic. It seems much too often I hear a parent say to me, “I am sick as well, so I went to the doctor who gave me an antibiotic for my cough and congestion, why aren’t you going to give an antibiotic to my child?”. They often follow this statement with, “I felt so much better after being on an antibiotic for several days….”, but I actually think many of them felt better as they were getting better on their own and not due to the antibiotic.
In this JAMA article it was noted that “prescribing rates were highest in children age 2 years and younger. (who also get the most viral URI’s in a year) . There were also distinctions in prescribing practices by region of the country with the West having a lower rate of antibiotic prescribing than the South.
So…looking forward to “sick season” I may be quoting this JAMA article when I once again explain to a parent, or a child….that their fever, cough and cold is due to a virus and that there is not the need for an antibiotic. In fact, a parent might want to boast, “my child has never been on an antibiotic”...which is a good thing. Save the prescription for a time when it is really warranted, and at the same time “pay it forward” by helping to prevent even more antibiotic resistance in this country.